Aboturkia AM, Ben Kridis W, Aqoup MO, Abdoalmola MO, Ben Ali S, Khanfir A. Diet and physical activity in colorectal cancer patients: A research protocol of a randomized controlled study. World J Gastrointest Oncol 2025; 17(8): 109579 [DOI: 10.4251/wjgo.v17.i8.109579]
Corresponding Author of This Article
Wala Ben Kridis, MD, PhD, Associate Professor, Department of Oncology, Habib Bourguiba University Hospital, University of Sfax, Avenue El Ferdaous, 3029 Sfax, Tunisia. walabenkridis@yahoo.fr
Research Domain of This Article
Oncology
Article-Type of This Article
Randomized Controlled Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Aug 15, 2025; 17(8): 109579 Published online Aug 15, 2025. doi: 10.4251/wjgo.v17.i8.109579
Diet and physical activity in colorectal cancer patients: A research protocol of a randomized controlled study
Ali Mohamed Aboturkia, Wala Ben Kridis, Mukhtar Omer Aqoup, Munir Omer Abdoalmola, Suhil Ben Ali, Afef Khanfir
Ali Mohamed Aboturkia, Department of Pathology, Azzaytuna University, Tarhuna 3022, Libya
Wala Ben Kridis, Department of Oncology, Habib Bourguiba University Hospital, University of Sfax, Sfax 3008, Tunisia
Mukhtar Omer Aqoup, Department of Genetics, Agriculture Research and Food Products, Authority Center Misurata Libya, Misurata 3028, Libya
Munir Omer Abdoalmola, Department of Reconstructive Surgery, National Institute Oncology Misurata Libya, Misurata 3028, Libya
Suhil Ben Ali, Department of Medical Oncology, National Institute Oncology Misurata Libya, Misurata 3028, Libya
Afef Khanfir, Department of Medical Oncology, Habib Bourguiba University Hospital, University of Sfax, Sfax 3008, Tunisia
Co-first authors: Ali Mohamed Aboturkia and Wala Ben Kridis.
Author contributions: Aboturkia AM and Ben Kridis W are listed as co-authors because they contributed significantly to the study’s design, data interpretation, and manuscript preparation; Aqoup MO was responsible for the statistical analysis; Abdoalmola MO participated in data analysis; Ben Ali S and Khanfir A revised the article; all the authors reviewed the manuscript.
Institutional review board statement: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and the Ethics Committee of the Faculty of Medicine of Sfax (ID: 61/24) National Cancer Institute Misurata (ID: 04/2023) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Clinical trial registration statement: This study is registered at https://clinicaltrials.gov/. The registration identification number is NCT06194786.
Informed consent statement: Informed consent obtained directly from patient(s).
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior authors or other coauthors who contributed their efforts to this manuscript.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wala Ben Kridis, MD, PhD, Associate Professor, Department of Oncology, Habib Bourguiba University Hospital, University of Sfax, Avenue El Ferdaous, 3029 Sfax, Tunisia. walabenkridis@yahoo.fr
Received: May 15, 2025 Revised: June 5, 2025 Accepted: July 9, 2025 Published online: August 15, 2025 Processing time: 91 Days and 10 Hours
Abstract
BACKGROUND
As the population of colorectal cancer (CRC) survivors continues to grow, the demand for effective, evidence-based post-treatment strategies becomes increasingly urgent. Despite robust evidence linking lifestyle factors to cancer outcomes, there remains no established consensus on the optimal nutritional and physical activity (PA) guidelines for disease-free CRC survivors.
AIM
To demonstrate that structured lifestyle interventions, specifically tailored dietary and PA programs, can significantly improve behavioral targets as well as disease-free and overall survival (OS).
METHODS
We designed a 2 × 2 factorial phase II randomized controlled trial to compare the effects of dietary and PA interventions with standard care.
RESULTS
A total of 300 CRC survivors in complete remission will be recruited from oncology centers in Misurata and Zliten (Libya) and the Habib Bourguiba University Hospital (Tunisia). Participants will be randomized into four groups: Combined intervention, diet-only, PA-only, or usual care. They will be followed for 24 months, with outcomes including disease-free survival, OS, and quality of life. Ethical approval has been obtained (Sfax ID: 61/24; Misurata ID: 04/2023), and the trial is registered at ClinicalTrials.gov (NCT06194786).
CONCLUSION
This study will provide crucial region-specific evidence on the feasibility and effectiveness of lifestyle interventions in CRC survivorship care. By evaluating the role of a high-fiber, low-red meat diet and structured PA, we aim to demonstrate the potential of these behaviors to improve survival outcomes and support their integration into future clinical practice guidelines.
Core Tip: The number of colorectal cancer (CRC) survivors is steadily rising, creating an urgent demand for effective and sustainable post-treatment care strategies. Although lifestyle factors such as diet and physical activity (PA) are known to influence cancer outcomes, there is a notable lack of evidence-based, structured programs to guide survivors in adopting and maintaining these changes—especially in African and resource-limited settings. This study evaluates the impact of two targeted behavioral interventions—increasing PA and reducing red and processed meat intake—on long-term outcomes in CRC survivors. It is among the first of randomized controlled trials in Africa to assess the combined and independent effects of these lifestyle changes on survival and quality of life. Our findings could transform survivorship care by providing region-specific evidence to support the integration of lifestyle counseling into routine oncology practice. This program may serve as a model for preventive care that improves both disease-free and overall survival while influencing future clinical guidelines and public health policy.
